Know that coronavirus image with red spikes? Here’s how the artists at the CDC created it.

The CDC's image of the coronavirus. (Alissa Eckert and Dan Higgins/CDC)

You’ve seen it.

Red spiky tufts punching out in every direction like menacing fists. Yellow and orange speckles dotting an undulating gray sphere. All of it floating in an ominous microscopic stew.

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It's the coronavirus, the image of SARS-CoV-2 now on countless websites, television broadcasts, newspapers and magazines across the globe.

Alissa Eckert and Dan Higgins of the Centers for Disease Control and Prevention are the artists who made it.

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Here’s how they did it.

Samples of the Centers for Disease Control graphic design plan for its information on the coronavirus outbreak. (Jarrad Hogg/CDC)

1. Game plan

When the coronavirus was just starting to emerge from Wuhan, China, one of the many parts of the CDC that sprang into action was the communications team. A campaign would be needed.

This type of quick response to an emerging health crisis comes from the Emergency Operations Center, according to Jarrad Hogg, a visual information specialist at the CDC. The emergency team asked Hogg to come up with a graphic design strategy for all the CDC’s information on COVID-19.

“The primary thought process was: ‘What can we design that will be uniquely CDC in appearance, but easily reproducible as our designers alternate work throughout the response,’” Hogg wrote in an email.

Early on it was decided that the CDC would need to create an image of the virus. This is where Eckert and Higgins come in. They are both medical illustrators and were brought into the project.

The two have worked together for 14 years and have teamed on numerous projects including imagery for ebola, anthrax and antibiotic resistance.

They hashed out a plan.

The six medical illustrators at the Centers for Disease Control and Prevention are, front row from left: Stephanie Rossow, Alissa Eckert and Jennifer Oosthuizen; and back row from left: Dan Higgins, team leader James Archer and Meredith Newlove. (CDC)

2. Research

A medical illustrator is part scientist and part artist. Eckert has an undergraduate degree in scientific illustration from the University of Georgia and a master’s degree in medical illustration from Medical college of Georgia. Higgins has a bachelor’s in fine art and graphic design from the University of Georgia and a master’s in biomedical illustration from the University of Illinois at Chicago. Both love art, both love science, and eventually both found the profession.

Eckert was studying to become a veterinarian but had been taking art classes for fun. Higgins said he always loved art then discovered his love of science in college.

A medical illustrator is a specially trained artist with advanced education in science, anatomy and art. They typically have a master’s degree, and there are only three accredited med schools in the U.S. that offer the program.

The Graphic Services Branch at the CDC has eight illustrators: six medical and two nonmedical.

Eckert and Higgins started researching the novel coronavirus, trying to understand what makes this virus unique.

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A virus is a particle of genetic material wrapped in protein. Eckert and Higgins worked with CDC scientists to understand what proteins are part of COVID-19. For a coronavirus, the spiky proteins on its outer shell give it a crownlike appearance and its name.

These S or “spike” proteins can attach to cells in a person once they breathe them in, according to an explainer by the National Institutes of Health. Once attached, the virus invades the cells and starts to make millions of copies of itself.

The infection in most cases gives a person a fever, cough and shortness of breath, according to the CDC. However, in severe cases the immune system overreacts, according to a New York Times explainer, and can attack the lungs and lead to acute respiratory syndrome, leading to hospitalization or even death.

Illustrators at the CDC looked for 3D models of proteins that are part of the COVID-19 virus in the RCSB Protein Database, a digital resource of molecular material for scientists and educators. This page is for the spike protein on the outside of the coronavirus. (HANDOUT)

3. Gathering parts

Looking for a scientifically accurate 3D computer model of a protein? The Protein Data Bank, a resource of more than 160,000 molecular files for scientists and educators is the place.

Specifically, for COVID-19, Eckert and Higgins needed three main outer proteins: the S or spike protein, the E or envelope protein and the M or membrane protein. The data bank had resources for S and E, but they had to make M themselves.

The images in the data bank are called 3D models, a type of digital file that can be rotated and modified in special software. A medical illustrator can use this software to tune the appearance of an image for a scientific journal, a web animation or a campaign to explain a worldwide health crisis.

Once Eckert and Higgins had all the parts in hand and had worked with CDC scientists on the structure of COVID-19, they were ready to begin perfecting the image.

This undated electron microscope image made available by the U.S. National Institutes of Health in February 2020 shows the Novel Coronavirus SARS-CoV-2. (AP)

Alissa Eckert and Dan Higgins, illustrators with the CDC, created this series of images to show how they refined the molecular shapes to create the well-known image of the coronavirus. (Alissa Eckert and Dan Higgins/CDC)

4. Refining

An electron microscope image of the coronavirus looks like blobs of small, hairy splotches. They are also black and white.

Creating a detailed, realistic-looking 3D sphere that conveys immediacy and clarity is where the art meets the science.

The 3D model files that come from the data bank are very, very complex and not necessarily ready to be published to a mass audience. Eckert and Higgins had to process those files in a program that simplifies and refines the forms.

Viruses are very small and what color they actually are, or whether they have color at all, is not known, Eckert said. Picking how to color it in comes down to what the illustrator is trying to communicate and where it is being communicated.

For the CDC image, Eckert and Higgins picked red for the S protein, orange and yellow for the M and E proteins and a grayish background for the oily viral wall. They worked hard to match their approach to the color scheme created by Hogg.

This image shows the three outer proteins on an illustration of the coronavirus particle. The S or spike protein, the E or envelope protein and the M or membrane protein. (Alissa Eckert and Dan Higgins/CDC)

“We tested different colors to see what was going to work in a combination for us, for our communication goals,” she said. “I didn’t want it to be too playful. For instance, I tried, like, the greens and blues, and it just didn’t speak to me at all, it just kind of fell flat. The red and orange combination was just very striking. It calls your attention and makes you look at it.”

“Next, we add lighting, texture and color to the model so that the model seems real, but also visually dynamic,” Higgins said.

The pair tuned the illustration for the particular job: To bring attention to the outbreak and education. “If this was supposed to be in a scientific journal, it probably would have looked different,” Eckert said. “Then you’re talking about strict data and that’s another problem to solve.”

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As part of our final steps, Eckert said, the image was submitted to the CDC’s quality assurance and quality control expert, to make certain it was in line with CDC’s expectations.

The CDC site on April 3, 2020. (CDC)

5. Getting the word out

The more than 50 designers in the CDC's Division of Communication Services with Hogg have worked constantly since those first days of the crisis.

Hogg said illustrations like the coronavirus image are critical to getting the CDC’s message out. “We rely on illustrations to help clarify the message, break up the content and enhance comprehension,” he said.

And as the story spread from an unknown virus in Wuhan to a worldwide pandemic, the image spread, too.

Could it be said the image has become the identity of the outbreak? “I keep saying people needed a face for the virus," Eckert said. “They needed a way to make something complex tangible and I think it did.”